Clinical profile and outcomes among neonatal pneumonia patients admitted in a tertiary care hospital, Gujarat, India

Abstract

Background: Neonates are highly vulnerable to infection due to factors like immaturity, immunologic deficiencies at time of birth and in-utero maternal infection. Neonatal pneumonia continues to remain important cause of mortality and morbidity in developing countries like India. The aim of this study was to study the clinical profile and outcome of neonatal pneumonia.Methods: This descriptive observational study was carried out at NICU of tertiary care hospital with level III nursery during August-October 2012. A total of 200 neonates admitted in NICU during the study period were included as per inclusion criteria. All neonates were observed on day of admission, on day of deterioration and day of discharge. Clinical parameters, investigation profile, probable aetiology, intervention required and outcome was noted.Results: Out of 200 neonates admitted during study period, 64 neonates were having neonatal pneumonia, making incidence of 32%. All symptomatic patients having respiratory distress were evaluated by taking blood samples for blood culture with antibiotic sensitivity, C-reactive protein, sepsis screen and X-ray chest. Onset of pneumonia was decided on basis of appearance of symptoms like early onset (<72hours) or late onset (>72 hours). Half of the patients had shown improvement after intervention but 16% deteriorated which required ventilatory support. Mortality was 32.81% and it was more in early onset (40%) than late onset (28.2%).Conclusions: There was no single parameter which can be used for diagnosis of neonatal pneumonia. Clinical features with chest X-ray with sepsis markers have to be considered in diagnosing pneumonia.